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Will Two New IHS Hospitals Tie Up Funding?

By Kevin Abourezk

Nearly $500 million in economic stimulus money will go to the Indian Health Service, the U.S. Department of Health and Human Services announced Thursday.

Of that, $227 million will be spent on construction of IHS facilities, $100 million on maintenance and improvements, $85 million on health information technology, $68 million on sanitation facilities construction and $20 million on health equipment.

HHS said money for construction will be spent, in part, on construction of the new Norton Sound Regional Hospital in Nome, Alaska. The hospital will replace a 61-year-old hospital that is too small to serve nearly 10,000 users, HHS said.

Further, the project will create a substantial number of jobs in Nome, which struggles with a 12.7 percent unemployment rate, according to the Bureau of Labor.

"The Recovery Act will help meet many critical health needs in Indian communities, create jobs and boost our economy," said IHS Director Robert G. McSwain.

The news supports information provided me last week by gaiashkibos, a Minnesota representative for the Midwest Alliance of Sovereign Tribes and former president of the National Congress of American Indians.

However, gaiashkibos - who was relating information given to him by an IHS official recently in Washington, D.C. - also said the money for new construction would be spent on a new IHS hospital in Phoenix.

HHS didn't say Thursday how construction of new IHS hospitals would affect funding for Indian health care in the coming years.

Gaiashkibos broached that topic briefly last week, saying money spent on new IHS hospitals likely would tie up funding for Indian health care in the coming years as federal officials worked to fund personnel and operating costs at the two new hospitals.

This week, a former IHS official added his voice to criticism of spending so much federal stimulus money on construction of new IHS hospitals.

"IHS builds a building and then essentially takes funds off the top of the inadequate annual Congressional appropriation increases to fund the added costs of the operation of the new building/program," wrote Duane Jeanotte, a former IHS deputy and chief financial officer, in an e-mail. "The effect of this is that what small percentage increase that might have gone to the operation of all IHS/tribally operated programs is diminished because the increase to the new facility for new staff and operational funds is funded first."

He said as long as Congress fails to appropriate adequate funding to operate new and existing IHS hospitals building new hospitals will only penalize those IHS and tribally operated health programs that aren't on the priority list for a new facility.

The Northwest Portland Area Indian Health Board has even called for a moratorium on construction of new IHS facilities until Congress begins appropriating adequate funding to new and existing Indian health care programs.

This is a problem communities and states are finding with federal economic stimulus money, which offers one-time funding to governments and institutions without any money to continue newly created programs. Some schools districts, for example, worry about creating new teaching positions if they are unable to find money to keep those new teachers employed.

The same problem appears to be facing Indian Country, which will certainly benefit from two new hospitals but also is likely to see health funding dry up in other places as a result of those new facilities.

Is this a deal we want to make? Do we forsake more evenly distributed health funds in coming years for two new hospitals that are likely to absorb funds needed dearly elsewhere?

I don't know, but it seems like robbing Peter to pay Paul.

I can only hope Congress will see the need to pay Peter back in the coming years.

Kevin Abourezk's "Red Clout" columns are available for syndication. Please contact reznet to purchase republishing rights.

Kevin Abourezk, Rosebud Lakota, is a reporter and editor at the Lincoln (Neb.) Journal Star. He writes reznet's "Red Clout" political blog and teaches reporting at the Freedom Forum's American Indian Journalism Institute. Abourezk was awarded a Casey Medal for Meritorious Journalism in 2006.

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